Osseous Sarcoidosis with a Solitary Lytic Skull Lesion: A Case Report

Abstract

Bone sarcoidosis is an uncommon manifestation of the multisystemic disease with skull involvement being rare. We present the case of a 32-year-old female who was referred by her General Practitioner with a left calvarial lesion on a background of previous unilateral 7th nerve palsy and diabetes mellitus. Images demonstrated a left frontoparietal calvarial osteolytic lesion. She underwent resection by the neurosurgical team with histopathological study revealing noncaseating granulomas, consistent with sarcoidosis. Given absence of other systemic features of sarcoidosis, she did not undergo systemic treatment.

Sarcoid Involving the Heart and Frontal Bone With Minimal Pulmonary Involvement

“…Patients with bone sarcoidosis are typically asymptomatic, 15 where the distal bones of the hands or feet are commonly involved 13 . Sarcoidosis affecting the skull is a very rare manifestation 12,16,17 . One systematic review of skull sarcoidosis revealed 22 case reports of patients presenting with a variety of clinical manifestations 17 .…”

“…13 Sarcoidosis affecting the skull is a very rare manifestation. 12,16,17 One systematic review of skull sarcoidosis revealed 22 case reports of patients presenting with a variety of clinical manifestations. 17 Most skull sarcoidosis cases involve women between the sixth and seventh decade of life with no prior history of systemic sarcoidosis.…”

Sarcoidosis with Severe Bone Involvement: A Case Report and Literature Review

“…For example, the phalanxes of the hands and feet show lytic lesions, while sclerotic lesions occur in spine involvement [ 27 ]. Sometimes sarcoidosis might cause malignancy in the bones; in these cases, biopsy is needed for differentiation from other bone disorders [ 28 ]. Sarcoidosis patients with bone involvement are more likely to suffer from multiple organ involvement (>3 organs) and tend to receive Infliximab treatment when compared with those without bone involvement [ 16 ].…”

Osseous manifestations of sarcoidosis

“…Skull lesions may have different character and can be a significant difficulty for diagnosis. A skull base mass lesion due to sarcoidosis was mimicking malignancy and a lytic lesion needs to be differentiated from other bone disorders [32]. A pediatric case of rapid-onset thoracic myelopathy due to a sarcoid lesion was reported in 9-year-old otherwise healthy girl [33].…”